Brain Activity Associated with Self-Injurious Thoughts and Behaviors: A Meta-Analysis of Neuroimaging Studies

Background: Neuroimaging studies have found abnormalities in a multitude of brain regions among individuals who experience self-injurious thoughts and behaviors (SITBs) including the orbitofrontal cortex (Mahon, Burdick, Wu, Ardekani, & Szesko, 2012; Jollant, Olie, Guillaume, & Courtet, 2011), the anterior cingulate cortex (Wagner et al., 2011), the midbrain/pons (Osuch et al., 2014), and the amygdala (Monkul et al., 2007). However, brain regions showing abnormalities vary considerably between studies making it unclear whether a single constellation of regions underlies SITBs. The present study aimed to provide a quantitative summary of the current literature via meta-analysis. Methods: A total of 57 studies were identified as examining structural and/or functional brain correlates of SITBs. Activation foci from the studies were subjected to quantitative meta-analysis using activation likelihood estimation (ALE). Separate ALE analyses were performed examining white matter integrity (e.g. diffusion-tensor imaging) and gray matter functional and/or structural abnormality, as well as analyses that separately examined different functional (task) groupings. Results: We found no statistically significant voxels associated with SITBs; these findings remain unchanged after considering a multitude of moderators.
Discussion: The results indicate that current neuroimaging research has not found consistent brain abnormalities associated with SITBs. Future studies may require more extensive data (larger sample sizes, more scans per individual) to identify consistent neural correlates. Additionally, longitudinal designs that can show the time precedence of neural abnormalities will be required to identify biomarkers that can detect vulnerable individuals prior to the occurrence of SITBs.